Wiki J3301 billing

[christiestump@gmail.com]

When administering less than 10mg, can we still bill J3301 with a quantity of 1? The code description states "10mg" and not "up to 10mg" as is the case for other drugs.

I understand on the facility side when the dosage is less than the amount indicated for the HCPCS code that it is acceptable to round up to 1 as the unit of measure. But does anyone have an authoritative source stating that also applies on the outpatient side?

Thanks in advance!

 

[ellzeycoding]

You have to round up. You can't bill .5 units or 1.5 units.

Here is a slide presentation from Noridian Mediare... See around page 7

https://med.noridianmedicare.com/documents/10529/2685782/Proper+Billing+and+Coding+of+Outpatient+Drugs+and+Biologicals+Presentation+-+December+2014/8c49ad53-6317-4f32-958f-6554099bc24a